Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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Clinicopathological aspects of and survival in patients with clinical stage I bronchioloalveolar carcinoma

Aspectos clínico-patológicos do carcinoma bronquioloalveolar e sobrevida em pacientes no estágio clínico I

Daniel Sammartino Brandão, Rui Haddad, Giovanni Antonio Marsico, Carlos Henrique Ribeiro Boasquevisque

J Bras Pneumol.2010;36(2):167-174

Abstract PDF PT PDF EN Portuguese Text

Objective: To analyze the clinicopathological aspects of bronchioloalveolar carcinoma (BAC) and the survival in a sample of patients at clinical stage I. Methods: A retrospective study involving 26 patients diagnosed with clinical stage I BAC and undergoing surgery at the Thoracic Diseases Institute of the Federal University of Rio de Janeiro, in the city of Rio de Janeiro, Brazil, between 1987 and 2007. We analyzed clinicopathological and radiological aspects, as well as mortality and survival. The data, which were collected from the medical charts of the patients, were statistically analyzed. Results: Females predominated (n = 16). The mean age at diagnosis was 68.5 years. Most patients were active smokers (69.2%). The most common forms of presentation of BAC were the asymptomatic form (84.6%) and the nodular form (88.5%). Involvement of the upper lobes predominated (57.7%). Stage IB was the most common pathological stage, followed by stages IA and IIB (46.2%, 38.4% and 15.4%, respectively). There was no in-hospital mortality. Four patients died during the postoperative follow-up, with a mean disease-free survival time of 21.3 months. The overall five-year survival rate was 83%. The probability of survival for the patients diagnosed after 1999 showed a trend toward an increase when compared with that for those diagnosed up through 1999 (three-year survival rate: 92% vs. 68%; p = 0.07). Conclusions: The clinicopathological aspects of this study sample were similar to those of patients with BAC evaluated in previous studies.

 


Keywords: Adenocarcinoma, bronchiolo-alveolar; Carcinoma, non-small-cell lung; Lung; Smoking.

 


Mitral valve obstruction by tumor embolus as a cause of irreversible cardiac arrest during right pneumonectomy

Obstrução de valva mitral por embolização tumoral per-operatória (pneumectomia direita) com parada cardíaca irreversível

Rui Haddad, Carlos Henrique Ribeiro Boasquevisque, Tadeu Diniz Ferreira, Mario Celso Martins Reis, Fernando D'Imperio Teixeira

J Bras Pneumol.2008;34(7):537-540

Abstract PDF PT PDF EN Portuguese Text

A 26-year-old patient with a voluminous primary pulmonary hemangiopericytoma in the right lung, diagnosed through previous surgical biopsy, presented irreversible cardiac arrest during the hilar dissection portion of a right pneumonectomy. The patient did not respond to resuscitation efforts. Autopsy showed total obstruction of the mitral valve by a tumor embolism. In cases of large lung masses with hilar involvement, as in the case presented, we recommend preoperative evaluation using transesophageal echocardiography, magnetic resonance imaging or angiotomography. If injury to the pulmonary vessels or atrial cavities is detected, surgery with extracorporeal circulation should be arranged in order to allow resection of the intravascular or cardiac mass, together with pulmonary resection. We recommend that care be taken in order to recognize and treat this problem in patients not receiving a preoperative diagnosis.

 


Keywords: Embolism; Heart arrest; Pneumonectomy.

 


Surgical treatment of a paratracheal bronchogenic cyst using cervical mediastinoscopy

Tratamento cirúrgico de cisto broncogênico paratraqueal por mediastinoscopia cervical

Daniel Sammartino Brandão, Carlos Henrique Ribeiro Boasquevisque, Rui Haddad, Eduardo de Souza Ponzio

J Bras Pneumol.2005;31(4):365-364

Abstract PDF PT PDF EN Portuguese Text

Bronchogenic cysts of the mediastinum are benign congenital lesions, usually found in adults. When surgery is indicated, the classical approach is resection of the lesion by thoracotomy or thoracoscopy. Herein, we describe the complete resection of a paratracheal bronchogenic cyst by cervical mediastinoscopy. We also include a brief review and discussion of the literature.

 



 

 


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E-mails: jbp@jbp.org.br
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